common post natal problems Flashcards
skin colour problems
jaundice
pallor
plethora
cyanosis
birthmarks
capillary hemangioma mongolian blue spot port wine stain stork marks cafe au lait spots giant melanocytic naevii
plethora
redness
vascular problems
polycythemia
cyanosis
peripheral: common, part of transition
central: needs Ix, O2 sats
jaundice causes: 1st 24hrs
sepsis
haemolytic
jaundice causes: 2nd day -2/3rd week
physiological
breast milk
sepsis
haemolysis
jaundice causes: prolonges
breast milk
hypothyroid
biliary obsruction - biliary atresia
Mx jaundice
treat underlying cause hydrate phototherapy exchange transfusion Ig
erythema toxicum
maculopapular rash
fades by end 1st week - no Rx needed
more common in term neonates - rare in preterm
mongolian bluespots
blue-grey pigmented areas
accumulation of melanocytes
often lower back and buttocks
commoner in races with pigmented skin
capillary vascular malformations
stork marks
port wine stain
stork marks
naevus simplex
light colour capillary dilatation, commonly back of neck. + midline of face
within 1st 2yrs life, gradually fades
port wine stain
naevus flammeus
present at birth: flat or slightly raised
caused by dilatation of mature capillaries in superficial dermis
doesn’t regress
port wine stain associations
klippel trenuany
sturge-weber syndrome
capillary heamangioma - strawberry naevus
cluster of dilated capillaries, appearing within 1st mo
raised and bright red, discrete edges, occuring anywhere on body
usually regress >1yoa
what happens to neonate in cold stress
reduced arteriolar oxygen
metabolic acidosis
hypoglycaemia
reduced surfactant production
management to prevent neonate hypothermia
dry quickly
remove wet linens
use warm towels
heated/humidified oxygen
hypoglycaemia
blood sugar <2mmol /l
hypoglycaemia: babies at risk
limited Glc supply: premature, perinatal stress
hyperinsulinism: diabetic mum
inc Glc use: sepsis, hypothermia
hypoglycaemia when can bedside tests be inaccurate
high or low levels
poor perfusion
polycythemia
hypoglycaemia best detection methods
blood gas machine
lab testing
hypoglycaemia features
jitteriness lethargy temp instability apnoea hypotonia poor suck/feeding high pitched cry seizures
tongue ties
short +/- thickened frenulum
attatched anteriorly - base of tongue
tongue tie management
most need none
frenotomy: if restriction tongue protrusion beyond alveolar margins and feeding is affected
evaluation of resp distress
resp rate: newborn tachypnoea >60/min
O2 sats
colour
inc work breathing: grunting, nasal flaring, retraction
what can absent/weak femoral pulses be a sign of
coarctation of aorta
cleft lip classifications
incomplete or complete (continues to nose)
unilateral or bilateral
cleft lip
maxillary and medial nasal proscesses fail to merge, usually ~5wks gestation
cleft lip issues
feeding problems
airway problems
assoc anomalies: hearing screen, ECHO
cataracts
lens opacification
can lead to blindness if undetected
Mx: nothing or lens removal and artificial lens
retinoblastoma
rare eye cancer
treated successfully if early detection
Rx: chemo, laster therapy, eye removal
pseudomenstruation
girls vaginal bleed 2-10days
sudden lack of oestrogen supply from mum
usually lasts ~2 days, harmless
spinal dimples
can reveal more serious abnormality involving spine +/- spinal cord e.g. spina bifida
spinal dimples: when to do no further investigations
small, close to anus, in midline, no assoc skin features
spinal dimples: when to do spinal USS
large, off midline, further away from anus and assoc cutaenous marker e.g. hair growth
cephaloheamatomas
localised swelling over 1 or both sides head
maximised by day 3/4life
soft, non-transculemt
beneath pericranium
cephaloheamatomas Rx
no rx neeed, resolution within 3-4wks
DDH
socket is shallow and not developed properly to hip has tendency to slip out and become dislocated
trisomy 21 features
low set ears epicanthic fold single palmar creases cardiac defects learning problems thyroid problems
